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W Brian Hyslop

Publications and source records attributed to W Brian Hyslop.

7 recordsLinked to original sources

MRI findings of primary small-cell carcinoma of kidney.

We report the MRI findings of primary small-cell carcinoma of the kidney (PSCCK) in a 59-year-old female. This tumor appeared as a 16-cm mass that arose from the right kidney. This lesion had diminished signal on T1-weighted images and heterogeneous mixed signal on T2-weighted images. The tumor primarily involved the renal medulla with persistent thin renal cortex. Despite the tumors' large size, no substantial central necrosis was present. The predominant medullary location and the lack of central necrosis in this large tumor were features unusual for renal cell carcinoma and should raise the suspicion of another malignancy, the differential diagnosis of which should contain extrapulmonary small-cell carcinoma of the kidney.

Carcinoma, Small Cell↗

Future horizons in MR imaging.

In this article, we defined the major areas of active research in clinical MR imaging. Further increases in the number of parallel coils within an imaging array and in advances in parallel imaging pulse sequences and postprocessing will lead to further reductions in imaging time analogous to the impact of multidetector CT on helical CT. The synergism between parallel and high-field imaging will aid the development of high-field imaging. The combined dynamic and hepatic parenchymal enhancement of new contrast agents that have or may soon receive FDA approval will enable improved detection and characterization of liver lesions. The lymphotropic SPIO agents will remain an active area of clinical research to further assess their role in oncologic staging. Molecular imaging contrast research using magnetic particles and MR microscopy will continue to flourish. Screening examinations by MR imaging will re-main an area of research for the short- and intermediate term, with the final outcome dependent more on socioeconomic costs than the underlying capability of achieving high-quality screening studies.

Contrast Media↗

Future directions in body magnetic resonance imaging.

Technologic innovations in instrumentation and contrast agents naturally lead to new clinical and research applications in body MRI. Although long-range predictions of innovation are an uncertain process, short-term trends in development are more readily discernable. This review will provide examples of recent developments in magnetic resonance spectroscopic imaging, contrast agent development and molecular imaging, instrumentation, post-processing, and screening in an attempt to describe areas of active research.

Contrast Media↗

MR imaging findings in autoimmune hepatitis: correlation with clinical staging.

PURPOSE: To retrospectively evaluate the morphologic and enhancement features of the liver on magnetic resonance (MR) images obtained in patients with autoimmune hepatitis (AIH) and to determine if there is a correlation between MR imaging findings and severity of clinical disease as measured with the Mayo end-stage liver disease (MELD) score. MATERIALS AND METHODS: This study was compliant with the Health Insurance Portability and Accountability Act and approved by the institutional review board. The need for informed consent was waived. Thirty-two patients (29 female and three male patients; mean age, 44 years; age range, 14-69 years) undergoing treatment for AIH underwent unenhanced and gadolinium-enhanced MR imaging. Two radiologists reviewed all cases independently to determine the presence of patchy or heterogeneous liver enhancement, biliary duct changes, lymphadenopathy, and findings of portal hypertension. Fibrosis was graded as mild, moderate, or severe reticular (corresponding to a grading scale of 1-3) or as confluent. Agreement between radiologists was assessed by using kappa coefficients. Mean MELD scores were compared across fibrosis categories by using the Kruskal-Wallis analysis of variance. RESULTS: Of the 32 patients, two (6%) had no imaging findings of cirrhosis. Thirty patients (94%) had reticular fibrosis with a mean grade of 1.8. Six patients had confluent fibrosis, and all six had associated reticular fibrosis. Mild intrahepatic biliary duct dilatation involving the right and left lobes was observed in four patients (12%). Lymphadenopathy was observed in 12% of patients. None of the patients had hepatocellular carcinoma. There was no significant overall association between fibrosis grade and MELD score (P = .36). CONCLUSION: Although fibrosis is a common feature in AIH and is often moderate to severe, no significant correlation between fibrosis grade and MELD score was found.

Adolescent↗

MRI of acute abdominal and pelvic pain in pregnant patients.

OBJECTIVE: The purpose of this study was to show the usefulness of MRI in the evaluation of pregnant women with acute abdominal or pelvic pain. SUBJECTS AND METHODS: All MRI studies of pregnant patients who were referred for examination because of acute abdominal or pelvic pain between June 2002 and May 2004 were included in this study (n=29). The use of MRI was at the discretion of the clinician. Fetal sonography was performed in all patients before any other imaging. A complete abdominal sonographic examination was performed in six patients before MRI. In the remaining 23 patients, MRI was the choice for primary imaging. Multiplanar multisequence MR images of the abdomen and pelvis were obtained in each patient. Unenhanced images were reviewed by an experienced radiologist to determine whether a diagnosis could be made without the administration of gadolinium. In 22 of 29 studies, gadolinium was not administered. The prospective clinical MR interpretations were compared with follow-up medical, surgical, and obstetric records to determine the correctness of the interpretation. All patients were followed up until the date of article submission or until the date of final chart entry. RESULTS: Correlation of prospective clinical MR interpretations with follow-up medical records showed correct identification of disease entities in all but one patient. In one patient, torsion of the ovary was neither described prospectively nor seen in retrospect. The following disease processes were correctly identified using MRI: appendiceal abscess (n=1), appendicitis (n=2), intraabdominal and rectus muscle abscess (n=1), intussusception (n=1), pancreatitis (n=1), ulcerative colitis (n=1), Crohn's disease with diffuse peritoneal inflammation (n=1), bilateral adrenal hemorrhage (n=1), pyelonephritis (n=2), hydronephrosis (n=1), uterine fibroid degeneration (n=2), degeneration and torsion of a submucosal uterine fibroid (n=1), simple ovarian cysts (n=1), and ovarian torsion (n=1). Twelve of the 29 patients had normal findings on MR examinations and unremarkable follow-up. CONCLUSION: The intrinsic safety of MRI and its ability to accurately show abdominal and pelvic disease in pregnant patients make it highly useful in the evaluation of these patients.

Abdomen, Acute↗

Suspected pancreatic cancer: evaluation by dynamic gadolinium-enhanced 3D gradient-echo MRI.

OBJECTIVE: The objective of our study was to determine the sensitivity and specificity of gadolinium-enhanced 3D gradient-echo (GRE) MR images in the detection of pancreatic cancer. CONCLUSION: Dynamic gadolinium-enhanced 3D GRE images are both sensitive and specific in the detection of pancreatic cancer. Our study shows that the identification of pancreatic cancer using these images can be performed with a high degree of confidence and accuracy, making them very useful in the detection of pancreatic cancer.

Adult↗

Immunoblastic large B-cell lymphoma of the peripancreatic head region: MR findings.

We report the magnetic resonance (MR) appearance of a large B-cell lymphoma in the peripancreatic head region, in a 38-year-old male who presented with a 1-month history of pruritus and jaundice. Routine laboratory examination at presentation revealed an elevated bilirubin. The tumor was a large, solitary well-defined mass with no evidence of necrosis, which showed mild diffuse heterogeneous enhancement. The tumor was closely applied to the lateral margin of the head of the pancreas. The constellation of MR findings was interpreted as consistent with the correct eventual diagnosis of lymphoma.

Adult↗